AMA Bookstore News, March 13, 2012
Product Showcase
CPT® 2013 Professional Edition
Correctly interpreting and reporting medical procedures and services begins with CPT® 2013 Professional Edition. Straight from the American Medical Association (AMA), this is the only CPT® codebook with the official CPT coding rules and guidelines developed by the CPT Editorial Panel. Covers hundreds of code, guideline and text changes.
Key Features:
- Improved! A comprehensive index—revised and enhanced for 2013 to better aid you in locating codes related to a specific procedure, service, anatomic site, condition, synonym, eponym, or abbreviation. An expansion of the pathology and laboratory index entries to include analytes and the elimination of redundancy throughout the rest of the index result in an index that is clearer and quicker to search.
- More! Anatomical and procedural illustrations—help improve coding accuracy and understanding of the anatomy and procedures being discussed. Five new illustrations provide more information for those coding from the Cardiovascular System subsection of Surgery.
- New! Listing of proprietary test names for multi-analyte assays—puts you ahead of the curve by informing you of existing tests that have yet to meet all of the necessary requirements to be placed among the Category I codes
- Updated citations to CPT® Assistant, Clinical Examples in Radiology, and CPT® Changes—gives you immediate information to popular AMA resources that can enhance your understanding of the CPT code set
- Summary of additions, deletions and revisions—provide a quick reference to 2013 changes without having to refer to previous editions
- Fourteen appendixes—offer you quick reference to additional information and resources that cover such topics as modifiers, clinical examples, add-on codes, vascular families
CPT® Changes 2013
Receive expert guidance on each change to the 2013 CPT code set direct from the American Medical Association (AMA).
This best-selling annual title serves as a reference tool to understanding each of the CPT® code changes found in the CPT® 2013 codebook. Organized in the same manner as the CPT codebook, this guide provides the official AMA rationales for every new, revised and deleted CPT code and guideline.
Key features:
- Organizational structure similar to the CPT codebook—allows coders to easily conduct a side-by-side read of CPT Changes with the CPT codebook
- Official AMA rationales—provide a detailed explanation for the code or guideline change
- At-a-glance tabular review of 2013 changes—show the extent changes affect a particular specialty
- Clinical examples, procedural descriptions and illustrations—help explain the practical application for each change
ICD-9-CM 2013 for Physicians, Volumes 1 and 2, Professional Edition
The updated 2013 edition delivers important diagnostic coding and reimbursement information. By integrating the Official Guidelines for Coding and Reporting into the ICD-9-CM code set, this codebook provides the information you need to ensure the most accurate billing for your physician practice.
The 2013 edition includes dictionary-style headings for quick reference and color coding and symbols to aid in code utilization.
Key features:
- Full-color Frank Netter anatomical plates—educate users about anatomy
- Companion Web site—provides the latest updates, an ICD-9-CM to ICD-10-CM crosswalk, and MS-DRG information
- Coding tips and notes developed by coding experts—define terms and provide additional coding instruction to aid in understanding difficult terminology, diseases and conditions, or coding in a specific category
- "Guide to 2013 Updates" section—lists all new, revised and deleted ICD-9-CM codes to help reduce denied claims due to outdated codes
- More than 200 code-specific color photographs and illustrations—help users visualize and recognize the disease referenced
- American Hospital Association's Coding Clinic for ICD-9-CM® citations—provide reference information regarding official ICD-9-CM coding advice that will enhance your understanding of specific codes
The product showcase featured in AMA Bookstore News changes with each edition. This offer is only valid until April 9, 2012. Sales, special promotion pricing and premium not available for wholesalers, resellers and bookstores. The AMA reserves the right to determine eligibility for all offers and promotions. Supplies limited.
Customers have been clamoring for a revised index to the CPT codebook, and the CPT Editorial Panel is fulfilling that wish for 2013. CPT Department staff is busy scrutinizing each individual index entry, searching for ways to fill gaps in missing information and eliminate redundancy in an effort to make searching clearer and quicker. The pathology and laboratory index entries will also expand to include new references to analytes. Both CPT® 2013 Professional Edition and Standard Edition will feature the much improved index.
For those who appreciate a visual approach to learning, the CPT® 2013 Professional Edition will include new illustrations in the Cardiovascular System subsection of Surgery. Such images help coders understand the anatomy and procedures being discussed in the descriptors.
And, to put you ahead of the curve, the CPT Editorial Panel will add a new appendix of proprietary test names for multi-analyte assays. CPT® 2013 Professional Edition is the only codebook offering you a comprehensive list of existing tests that have yet to meet all of the necessary requirements to be placed among the Category I codes.
Loyal customers who purchase the CPT® 2013 Professional Edition direct from the AMA will be rewarded once again with the handy CPT® 2013 E/M Express Reference Tables Pocket Guide. This convenient guide summarizes the requirements for reporting E/M services and helps physicians and coders select and validate proper E/M coding.
There’s no time like the present to place your order for CPT® 2013 Professional Edition. The AMA’s core coding line for 2013 can be accessed via our AMA Bookstore and pre-orders are being accepted now.
Purchasers of the HCPCS 2012 Data File should be aware that CMS has released corrections to the 2012 code set.
Released on Jan. 30, the corrections include indication of three deleted codes, three revised descriptors, three revised effective dates, and 12 revised indicators. More information can be obtained through CMS.
Quarterly updates for Q2 2012 are also posted to the CMS website. The updates include removal of two modifiers, five new S codes, and 20 deleted S codes.
The HCPCS corrections and updates will be a part of the AMA’s regular quarterly update to the HCPCS Data File. If you’ve purchased your 2012 file, watch your email for the arrival of the Q2 April update.
And for a quick link to updates and news regarding the HCPCS code set, bookmark the HCPCS Special Announcements and Reports page of the AMA website.
Physicians received a 10-month reprieve from a 27-percent cut in Medicare payments scheduled for March 1, extending current payment rates through the end of the year, under an agreement reached by a House-Senate conference committee. The agreement is part of a deal to extend a payroll tax cut and added unemployment benefits. This is the 14th short-term patch to the SGR in the last 10 years.
Because Congress once again failed to repeal the SGR, the AMA projects that the next cut, scheduled to occur on Jan. 1, 2013, will be approximately 32 percent.
The AMA launched a campaign in early 2012 to urge patients and physicians to tell Congress that the time for repeal of the broken Medicare physician payment formula is now. Campaign videos—one geared toward Congress and the other toward seniors—warn that temporary patches to the SGR threaten access to care and choice of physician for seniors while increasing the taxpayer burden.
Obtain historical and up-to-date information on the SGR and its influence on the RBRVS with the 21st edition of Medicare RBRVS 2012: The Physicians' Guide or RBRVS Data Manager Online.
Medicare’s National Correct Coding Initiative (NCCI) edits are in place to prevent payment when certain code combinations are reported. The NCCI edits apply only to services that are performed on the same day for the same patient and billed by the same physician or facility (eg, on the same claim form). This means that studies performed by different physicians on a single patient on the same day, or studies performed by the same physician for the same patient on different days, are not subject to NCCI edits.
Example 1
As indicated in code 79101, Radiopharmaceutical therapy, by intravenous administration, and code 78452, Myocardial perfusion imaging, tomographic (SPECT) (including attenuation correction, qualitative or quantitative wall motion, ejection fraction by first pass or gated technique, additional quantification, when performed; multiple studies, at rest and/or stress (exercise or pharmacologic) and/or redistribution and/or rest reinjection, are paired because it is highly unlikely for a patient to receive radiopharmaceutical therapy by in-travenous injection and a myocardial perfusion study on the same day or during the same session. A modifier in-dicator of “0” marked on a code edit signifies that the codes should not be billed together by the same physician for the same patient and that only one service will be paid regardless of the circumstances.
Example 2
Although code 79101, Radiopharmaceutical therapy, by intravenous administration and code 78306, Bone and/or joint imaging; whole body, also represent a code combination listed as a NCCI edit, it is not uncommon for a patient to have a whole body bone scan performed initially to assess the extent of bone metasta-sis prior to receiving treatment with Samarium-153 lexidronam. The modifier “1” indicator recognizes that there are clinically valid instances when the “column 2” procedure would be performed in addition to the “column 1” pro-cedure by the same physician for the same patient on the same date of service. Therefore, it is appropriate to bill both codes as long as the procedures are separate and distinct, medical necessity is documented in the report, and an appropriate modifier is appended to one of the codes.
Question: Where can I find information about the current National Correct Coding Initiative edits?
Answer: National Correct Coding Initiative (NCCI) edits are available on the Centers for Medicare & Medicaid Services (CMS) website. NCCI edits are updated quarterly and should be checked throughout the year to identify the current NCCI edits in place. The NCCI edits are in place to prevent payment when certain code combinations are reported. When NCCI edit code-pair combinations are incorrectly reported, your institution or office will be notified of the specific edit and the charges that need to be removed or corrected. Once revised, charges can then be resubmitted.
Looking for more information on NCCI edits? Be sure to check out Understanding Medicare's NCCI: Logic and Interpretation of the Edits. And for more coding Q&A subscribe to CPT® Assistant Newsletter today!
CodeManager® Online: Elite is the AMA's premier, web-based coding and payment reference tool. Combining all of the medical coding references you need to code accurately and efficiently, this top tier of CodeManager is updated monthly to ensure you have the latest data available.
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Attending the AAPC National Conference in Las Vegas? Stop by AMA Booth 200 to take a test drive of CodeManager Online and the other AMA Coding Online products. Daily demonstrations will be held and AMA representatives will be available to answer any questions.
View the full CodeManager Online: Elite product description.
Essential Elements of the AMA Guides™ Sixth Edition
Faculty
Marjorie Eskay-Auerbach, MD, JD, FAADEP, is a board certified orthopaedic surgeon and a fellowship trained spine surgeon. She completed law school at the University of Arizona College of Law and was admitted to the State Bar of Arizona in May 2000. Dr. Eskay-Auerbach has been working and lecturing in the workers' compensation field since 1994 and has numerous publications and presentations to her credit. She is currently in private practice, evaluating and treating patients with work-related injuries and performing independent medical evaluations. She is a member of the American Academy of Disability Evaluating Physicians' board of directors, a contributing editor to the Guides Sixth, and has authored chapters for several AMA publications.
Essential Elements of the AMA Guides™ Sixth Edition: A course for physicians
This activity has been approved for 11.25 AMA PRA Category 1 Credits™*.
Details and agenda
This two-day training seminar will focus on using the Guides to the Evaluation of Permanent Impairment, Sixth Edition, (Guides Sixth) to accurately assess impairment. Designed for physicians and the workers' compensation community, this program covers a step-by-step progression of the impairment calculation for conditions and injuries related to individual body systems.
March 30-31, 2012
Day one: 8 a.m. – 5:00 p.m.
Day two: 8 a.m. – 2:30 p.m.
Price: $549
Include a copy of the Guides Sixth publication: $685
AMA member price: $449
Include a copy of the Guides Sixth publication: $585
Optional: Certification in the Evaluation of Disability and Impairment Rating (CEDIR) exam
Price: $275.00 (save $200)
Hosted at the American Medical Association headquarters
515 N. State St.
Chicago, IL 60654
Understanding Essential Elements of the AMA Guides™ Sixth Edition: A course for non-physicians
This activity has been approved for 6.75 Illinois MCLE general credit hours.
Details and agenda
This one-day educational seminar will deliver a clear understanding of the AMA Guides™ philosophy and the Illinois law that requires that the Guides Sixth be used to assess impairment for injuries that occur on or after Sept. 1, 2011. Ideal for defense attorneys, judges, corporate attorneys, raters, adjusters, claims managers, arbitrators, state employees, case managers and paralegals.
Date: March 29, 2012
8 a.m. – 5:15 p.m.
Price: $395
Include a copy of the Guides Sixth publication: $531
Optional: Certification in the Evaluation of Disability and Impairment Rating (CEDIR) exam
Price: $275.00 (save $200)
Hosted at the American Medical Association headquarters
515 N. State St.
Chicago, IL 60654
Stop by Booth 200 April 1-4 at the 2012 American Academy of Professional Coders National Conference to participate in live AMA Coding Online demonstrations and take advantage of special offers, including free shipping and discounted pricing on all AMA products! Demonstration attendees receive a free Starbucks gift card and are automatically entered to win exciting giveaways! Featured publications include the new, Advanced Anatomy and Physiology for ICD-10-CM/PCS as well as other ICD-10 preparation titles and the 2013 CPT® core coding line.
Can't attend these conferences? Visit amabookstore.com or call (800) 621-8335 to learn more!
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